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TOPIC TITLE: Question about what's reasonable with insurance
Created On 1/8/15 6:44 AM
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mouse
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Posts: 1931
Joined: Oct 2007

1/8/15 6:44 AM
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I was seeing a therapist for a long time. Insurance changed and she wasn't on their list. They won't take her either since her fees and other issues won't match up. Meanwhile I have been out of a therapist since May when we found out about the insurance change. The diagnosis is DID, PTSD, depression and such. I requested the insurance company to find someone for me since I was out of ideas. No one who specialized in DID/PTSD had the hours I needed (or were just not available) in the proper location. Am I asking too much for someone to have experience with DID/PTSD??? They suggested someone and the person worked with only one other DID person ever in her practice. Should I request another name???? Also, I can't travel 1/2 hr by car due to problems with my arms. Is that too much to ask for. I don't live in NY but neither do I live far away from people. Normal suburban neighborhood. Am I being too picky or should I insist?


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All the king's horses and all the king's men couldn't put Humpty Dumpty together again.
 
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Dr. Price MD
Psychiatrist

Posts: 1946
Joined: Jan 2006

1/8/15 6:49 AM
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You can ask that your original doctor be covered out of network since there are no other qualified specialists in network. Let me know how you make out.

Rabbi Price, M.D.
www.RabbiMD.com
 
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mouse
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Posts: 1931
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1/8/15 6:16 PM
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Can't afford the out of network charges. They are steep. I called the insurance company and explained the person they found for me only worked with one DID/PTSD patient in the past. The company in return said, she said she was qualified so she must be. I have lots of thoughts but expressing them is not going to help much. Their actions did just make me much more depressed than I've been in a while. They refuse to help find another provider besides giving names because I could see this one who is ever so qualified according to them. Any ideas???


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mouse
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1/13/15 6:40 PM
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Dr. Price, given what I wrote in the post 1/8, do you have any other ideas of how to deal with the insurance company??? I need a trustworthy therapist and they cannot provide one although they refuse to admit it. (In part they don't admit it because the thereapist claimed ability to deal with dissociative disorders when in fact she only dealt with one person once who had it.) How do I get a therapist to admit she's out of her league???


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Dr. Price MD
Psychiatrist

Posts: 1946
Joined: Jan 2006

1/13/15 9:21 PM
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Present the therapist with your most challenging material. When the therapist concedes that it is out of their league, ask for a referral letter to the therapist of your choosing to submit to the insurance company.

Rabbi Price, M.D.
www.RabbiMD.com
 
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mouse
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Posts: 1931
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1/19/15 8:24 AM
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I found someone finally with openings in the right specialty who may be sane.....a few thing bug me, but I'll temporarily look the other way for the time being.


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